<%@ page language="java" contentType="text/html; charset=utf-8"
    pageEncoding="utf-8"%>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=ISO-8859-1">
<title>Insert title here</title>
</head>
<body>
<div style="padding:15px 30px">
	<form id="preForm" method="post">
		<input type="hidden" name="id" />
		<div style="margin-bottom:20px">
            <input class="easyui-textbox" name="seeDoctorRegisterId" style="width:95%" data-options="label:'就诊登记编号:',required:true">
        </div>
		<div style="margin-bottom:20px">
            <input class="easyui-textbox" name="patient.id" style="width:95%" data-options="label:'病人:',required:true">
        </div>
        <div style="margin-bottom:20px">
            <input class="easyui-textbox" name="days" style="width:95%" data-options="label:'天数:',required:true">
        </div>
        <div style="margin-bottom:20px">
            <input class="easyui-textbox" name="dispensing" style="width:95%" data-options="label:'是否发药:',required:true">
        </div>
		<div style="margin-bottom:20px">
            <input class="easyui-textbox" name="state" style="width:95%" data-options="label:'state:'">
        </div>
	</form>
</div>
</body>
</html>